Mitigating Panic and Anxiety to Revisit a Place of Trauma

On August 10, 2022, I wrote about how I reached a milestone in my trauma recovery, specifically, how I managed through a potentially high-triggering event without incident. The most significant milestone will arrive this weekend when I return to where the worst part of the trauma occurred. I'm trying to be proactive in my preparations by taking stock of the panic- and anxiety-mitigation tools I have at my disposal.

2 Steps I'm Taking to Help Mitigate Panic and Anxiety

It may not seem like a lot—just two steps—but each step helps me inch closer to living a life free of fear of recurrence of the crippling panic and anxiety I suffered last year.

1. Go to therapy.

The most obvious step is to ensure I see my therapist before I go, which I've done twice since the milestone I wrote about on August 10.

In the past, I've written about my experience with eye movement desensitization and reprocessing (EMDR) therapy. My therapist and I have been working on processing the trauma I experienced by looking back at it and considering the distress levels I feel when discussing the worst parts of the memories. Knowing that I would be revisiting the site of the trauma in the near future, we planned for and reached a point in the EMDR therapy where it was time to imagine a future scenario—imagining myself returning to the place where the trauma occurred and processing the distress I feel about going there again.

My therapist guided me to the point where I imagined myself in the very spot where the worst part of the trauma occurred. At first, my brain just didn't want to go there. I drew a blank. My therapist reassured me that I was not alone and patiently waited for my psyche to advance.

Within minutes, I was crying, and my anxiety was rising. I was there, in that place, terrified that the panic and anxiety would again overtake me and that I would be defenseless to stop it. I talked about myself both as myself and as someone watching over me. At the beginning of the session, I was the frightened child. By the end of the session, I was the protector.

2. Take stock of my panic- and anxiety-mitigation tools.

Before I leave, I'm taking stock of what I've learned about the physiology associated with panic and anxiety and the skills I've acquired since the traumatic events of last year.

Thanks to my therapist and a few podcasts, I now have a rudimentary understanding of brain function. Here's my take on it.

The top of our brain is responsible for higher brain functions, such as reasoning and logic. The lowest parts of our brain—commonly referred to as the reptilian brain—control vital life functions such as breathing and heart rate. Our breathing can be somewhat controlled—I can purposefully hold my breath to go underwater—while other lower brain functions can't—I can't deliberately increase or decrease my heart rate. It's also the reptilian brain that governs our fight-flight-freeze response.

The most important thing I learned is that the higher and lower parts of the brain are like estranged siblings; they're related but don't talk to each other. That's why reasoning my way out of a panic attack or elevating anxiety doesn't work. However, I can use my higher brain function to control my breathing which will help regulate my heart rate, signaling my fight-flight-freeze response to stand down.

Of course, it's not that simple. That's when the other items in my toolkit come in handy, for when I feel panic or anxiety.

Toolkit for Mitigating Panic and Anxiety

1. Concentrate on controlled breathing. Here are two types of controlled breathing I use:
   • Candle breathing is a slow intake of breath through the nose followed by a slow—you don't want to blow out the candle—exhale through the mouth.
   • The physiological sigh begins with a slow intake of breath through the nose. Nearing the end of the inhalation, take another quick breath, then exhale slowly through the mouth.
2. Listen to bilateral music.   
   • Listening with headphones, the music's volume rhythmically increases and decreases in alternating ears, which can be calming. (Warning: while this music works for me, bilateral music should be experimented with to determine if it's right for you.)  
3. Stimulate the vagus nerve. "What Is Vagus Nerve Stimulation for Bipolar Depression?" explains the vagus nerve far better than I could. Here's one method my therapist taught me on how to stimulate the vagus nerve:  
   • Put your finger in the hollow above the ridge just above the ear canal. Don't press too hard. Be sure to move the skin of your ear as you gently massage inside the hollow in a circular motion. You may feel some physiological changes. You may sigh or yawn or not. It's all good. 
4. Take medication.   
   • As a last resort, and with a reminder to myself and others that there is no shame in it, I can take the medication prescribed for this purpose. It helps balance me if I'm in a state of panic or anxiety where all other calming measures have failed.  

I believe that proactive preparation before revisiting the place where my traumatic event occurred is vital to my continued recovery and overall success. I've learned a lot in the year since I started trauma therapy. Taking stock of what I've learned and reminding myself that I have new skills will help mitigate panic and anxiety before, during, and even after revisiting the place that changed my life. I've worked hard to get to where I'm going. Along with my other affirmations, I've added a new one: "I can do this."